Fehér K G, Zahumenszky Z, Fehér T, Bányai B
Z Rheumatol. 1980 May-Jun;39(5-6):176-81.
The individual protein fractions, together with the unbound (biologically active) and specifically globulin-bound 11-hydroxysteroids, were determined in the plasma and synovial fluid of patients with rheumatoid arthritis (RA). The values were compared with those measured in control subjects and in patients with severe osteoarthrosis (OA). Hypoalabuminaemia and hyperglobulinaemia, as well as an increase in the unbound and a decrease in the specifically bound corticosteroids were found in the plasma of the RA patients. The protein and corticosteroid levels were lower, and the level of the protein-bound corticosteroid fraction higher, in the synovial fluid than in the plasma. Significant differences between the RA and OA patients in respect of these parameters were also observed. The findings indicate that the altered hormone pattern is not a nonspecific result of the permanent stress situation to which RA patients are subjected. They point out the existence of a fairly specific but still unknown mechanism that compensates the high level of unbound corticosteroids, thus accounting for the absence of any clinical signs of hypercortisonism.
对类风湿性关节炎（RA）患者的血浆和滑液中的各个蛋白质组分，以及未结合的（生物活性的）和特异性球蛋白结合的11-羟基类固醇进行了测定。将这些值与在对照受试者和重度骨关节炎（OA）患者中测得的值进行比较。在RA患者的血浆中发现了低白蛋白血症和高球蛋白血症，以及未结合的皮质类固醇增加和特异性结合的皮质类固醇减少。滑液中的蛋白质和皮质类固醇水平低于血浆，而蛋白质结合的皮质类固醇组分水平高于血浆。在这些参数方面，RA患者和OA患者之间也观察到了显著差异。研究结果表明，激素模式的改变并非RA患者所面临的长期应激状态的非特异性结果。它们指出存在一种相当特异但仍未知的机制，该机制可补偿高水平的未结合皮质类固醇，从而解释了为何没有任何皮质醇增多症的临床体征。
